"I give up a little bit of my world each day"

NPR is running an extraordinary series on the return of a disease we thought we had beaten:

The Federal Coal Mine Health and Safety Act of 1969 was supposed to sharply cut exposure to coal mine dust. The act set a standard for coal dust exposure (2 milligrams per cubic meter of air), which was as little as 1/4 of the concentrations miners breathed at the time.

The act's passage followed a 23-day unauthorized and rowdy strike in which 40,000 West Virginia coal miners demanded government efforts to prevent the disease and to compensate victims.

By the end of the year, tough dust exposure limits were in place. Miners were offered free diagnostic chest X-rays every five years, and federal compensation became available. The X-rays showed 4 in 10 miners tested had black lung. The disease killed 1,800 miners in a single year. But diagnoses soon plunged more than 90 percent, according to NIOSH data.

"They anticipated that no one would develop progressive massive fibrosis," says 84-year-old Donald Rasmussen, a pulmonologist in Beckley, W.Va., who says he's tested 40,000 coal miners in the last 50 years.

"In 1969, I publicly proclaimed that the disease would go away before we learned all about it," he adds. "And I was dead wrong."

Rasmussen first started charting an increase in serious black lung cases about 15 years ago.

"We began to see the appearance of younger miners who had worked in the mines only since the dust suppression following the '69 act that were showing up with complicated pneumoconiosis or progressive massive fibrosis," he says.

Since 1970, NIOSH epidemiologists documented test results for 43 percent of the nation's coal miners. In 1995, the tests began to indicate more and more black long, rapid disease progression and the unexpected occurrence among relatively young miners.

"From the patterns and from the severity, from the prevalence of the disease, this must be a situation in which the dust in many, many mines is simply not adequately controlled," says Edward Petsonk, a pulmonologist at West Virginia University and a consultant for NIOSH. "There's nothing else that could possibly cause this."

And its human toll:

"Now it feels like I've got a heavy wet sack on each lung," McCowan says, between long, deep breaths. "Breathing has become a conscious effort. ... It seems like I give up a little bit of my world each day, that it gets smaller and smaller." 

Simple tasks become enormous challenges — "a Mount Everest every day," he calls it — including holding his 2-year-old grandson.

"I say, 'Little buddy, I got to put you down for a few minutes,'" McCowan says with a deep sigh. "And he's learned to run a little bit. He'll say, 'Run, paw-paw, run.' He wants me to chase him. And I can't."

The sad part is the may not be the worst education reform proposal I've seen.

From the in box

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I suspect that English may not be the first language here.

Quote of the day

Matt Yglesias:

I'm not much of a car guy, but the way I understand this metaphor to work is that if you want to give rich people credit for being "the engine of the economy" then if the economy is performing subpar it follows that something's wrong with your engine. And yet I suspect Zambrelli wouldn't take kindly to that diagnosis.

I actually found this interesting as it speaks to an odd sort of logic.  People wanting to claim credit for the good pieces but not for the bad ones (like economic downturns).  And yet if you want the credit for good performance you really ought to take your lumps for when things are bad. 

The increasingly self-serving ethics of journalism

(As usual, Brad DeLong gets credit for spotting this one)

Just to recap, I've been complaining (whining, moaning, bitching, etc.) about the state of journallism for a while. Many of those complaints assume (explicitly or implicitly) that journalism is forming a dangerously insular and cohesive group identity (I'm writing outside my field so my terminology might be a bit off -- if a social scientist out there has any notes, I'm open to suggestions).

Assuming I'm on to something here, one of the things we would expect is an ethical code that has notably different standards of behavior inside and outside of the group. Intra-group crimes (like plagiarism where the primary victim is another journalist) would be viewed as grave while offenses against subjects and readers would be seen as less serious. This difference would be particularly notable where journalists and non-journalists are mutually responsible for an offense.

Which takes us to the example of the day. As you probably know, the recent health care decision has produced as usual amount of leak-driven coverage. This has deeply offended Charles Lane of the Washington Post. Here's are some of the phrases that Lane uses when discussing the leaks and leakers:

"slimy"

"oozing slime"

"Cassius and Brutus inside the court, creeping up behind the chief justice with their verbal daggers"

"shame on the treacherous insiders"

And here's how Lane talks about Jan Crawford, the reporter who published the leaks,

"a fine journalist"

"kudos to Jan Crawford for a nifty little scoop"

According to Lane, Crawford's story damages the Supreme Court and misleads the reader, but the responsibility is apportioned so that all of the blame falls on the sources for passing the story on to the reporter. He even goes further and praises the reporter for passing the story on to us.

I suppose it might be possible to come up with a situation where two parties knowingly work together to produce something bad for society and yet one party shoulders all of the blame while the other is praiseworthy but Lane is no where near making that case here, nor does he seem to realize that he needs to.

One more locavore note

While I was looking up background on Pierre Desrochers (author of the Locavore's Dilemma) for the last post I noticed a favorable notice by Tyler Cowen and it got me thinking. Cowen is well known as what we used to call a gourmet. He has written extensively and knowledgeably on all matters culinary. He obviously cares deeply about good food.

As mentioned before, Desrochers is a defender of the far-traveled Florida tomato, a type of produce notable only for its durability (as described here by Barry Estabrook, author of Tomatoland, in an NPR interview):

Yeah, it was in southwestern Florida a few years ago, and I was minding my own business, cruising along, and I saw this open-back truck, and it looked like it was loaded, as you said, with green apples.

And then I thought to myself wait, wait, apples don't grow in Florida. And as I pulled up behind it, I saw they were tomatoes, a whole truckload mounded over with perfectly green tomatoes, not a shade of pink or red in sight. As we were going along, we came to a construction site, the truck hit a bump, and three or four of these things flew off the truck.

They narrowly missed my windshield, but they did hit the pavement. They bounced a few times, and then they rolled onto the shoulder. None of them splattered. None of them even showed cracks. I mean, a modern-day industrial tomato has no problem with falling off a truck at 60 miles an hour on an interstate highway.

I can't help but wondering what it would take to get Cowen to actually eat one of these things.

"Is not" journalism and our excessive tolerance of silliness

On Marketplace yesterday, Pierre Desrochers, author of the Locavore's Dilemma, presented his case against locavores. It did not go well.

There are good arguments against the locavore movement, that it's a distraction, that it isn't scalable, that it's a solution only available to the well-off, that the superiority of local produce is largely due to suggestion, that there's no good business model to support it, that frozen vegetables are actually more nutritious. I don't necessarily agree with all of these, but they're serious arguments that an advocate of the locavore movement have to address.

Desrochers doesn't make any of these arguments, nor will you see him addressing issues like asymmetry of information or monocultures. Instead we get what we so often get from contrarians, shrill and unadulterated silliness. The bar for these "is not" pieces is so embarrassingly low as to barely exclude grunts and spit bubbles. In this case, Desrochers' "arguments"* depend on the following assumptions:


1. Almost everyone will become a locavore;


2. Rather than trying to eat more locally grown food, locavores will eat nothing but local;


3. Even in times of shortage and crop failure, there will be no imports;


4. and despite all of this locavores will continue eating the exact same food in the same seasons.


On top of this, Desrochers doesn't even seem to have kept up with the debate. Consider this:

It's better to grow tomatoes in the Florida sun than in a heated greenhouse in upstate New York because the energy required to transport them 1200 miles is only a fraction of that required to heat greenhouses for several weeks. 

Florida tomatoes are literally the worst possible crop  to use as an example here.

In addition to being tasteless, Estabrook also points out that compared to tomatoes from other sources or from a few decades ago, the modern Florida variety have fewer nutrients, more pesticides (particularly compared to those from California), and are picked with what has been described as 'slave labor' (and given the use of shackles this doesn't seem like much of an exaggeration). 

Estabrook's book got a tremendous amount of press and it's hard to imagine that anyone who encountered any of that coverage would use Florida tomatoes as an anti-locavore example.
By the same token it's hard to imagine that anyone who had been following the discussion of the trend toward fewer varieties of crops with more geographic concentration would use blights and pests to support the status quo as Desrochers does.

I don't want to spend too much time on the locavore debate (if that's what you're looking for, Felix Salmon's a good place to start ). What interests me here is the journalistic phenomena of is-not-ism, We start with a trendy, over-hyped movement. For bonus points, its promoters tend to be self-satisfied, upper class liberals, they kind who annoy even other liberals.

At this point, if you can get someone with reasonable credentials to write an "is not" book taking the opposite position, that's really all that's required. The actual content doesn't matter. Commentators of similar persuasion will promote the book (even those who are smart enough to see through it).. Mainstream media outlets will give the authors airtime in the name of openness and balance.

>But openness to new ideas is only a virtue if it's accompanied by some sort of critical facility. We need to start recognizing silliness again and, more to the point, we need to start demanding more.

"Does Medicaid Make People Healthier?"

From NPR's Planet Money:

On the face of it, it seems like Medicaid would make people healthier, by giving them access to health care they wouldn't otherwise be able to afford. 

But there is a counterargument. It says that being on Medicaid is really worse for you than being uninsured, because it provides you with such low-quality health care. 

The debate has raged for decades because every study has lacked a control group. There was no way for researchers to randomly assign people to either receive Medicaid or go without. The Oregon lottery allowed them to do just that. 

Katherine Baicker, a professor of health economics at Harvard University, compared those who won the lottery, and those who entered but did not get covered. 

Fifty thousand mail surveys and 750 in-person interviews later, they concluded that Medicaid did, in fact, make people healthier. 

"People reported their health to be much better once they were insured," Baicker says. "The probability that they reported themselves to be in good, very good or excellent health increased by 25 percent." 

People on Medicaid were far less likely to borrow money or have a medical bill sent to a collection agency. And total health care spending (including what is covered by insurance) increased for people on Medicaid.

Happy 4th from 1909

Full Employment

This really is a good point from Matt Yglesias:

One concept that I was surprised to see both sides of the debate leave off the table is full employment. Nothing is quite so empowering in the workplace as the knowledge that if your boss treats you like a jerk, you'd be able to quit and go get a roughly similar job with a less jerky boss. Even a guaranteed social minimum isn't nearly as good as another job because there's disapprobrium attached to being unemployed. In a world of human beings, some bosses are always going to be two standard deviations jerkier than the average boss. Full employment punishes asshole bosses as a class rather than seeking to bureaucratically circumscribe them with a narrow list of specific prohibited abuses. Conversely, most of the pragmatic economic arguments against labor market regulation are developed assuming a background condition of full employment. If governments are going to fail to deliver full employment over extended periods of time (as the governments in the US, EU, Japan, and UK are doing right now) then all those assumptions are thrown out of whack. Both those who yearn for micro-efficient labor markets and those who yearn to empower people vis-a-vis their bosses have an enormous amount to gain from a robust full employment agenda.

In this case, I am very sympathetic to Matt's view here.  A lot of the issues about employment regulations go away when people have labor market mobility.  I have worked in a "at will" employment environment in a full employment environment and it never bothered me in the least.  After all, so long as I was an effective employee my employer would have been nuts to let me go.

In the same sense, the ridiculous rules linking employment to health insurance drastically reduce labor mobility once you enter your forties and develop medical conditions.  In this sense, the health insurance exchanges of ACA will help this issue a lot.  Still, if people could easily change jobs most of the paradoxes of employment regulation would go away.

So clearly the best way to improve people's lives would be to create economic opportunity.  If people who want to work are able to do so then a surprising number of difficult (nearly intractable) problems can end up being somewhat beside the point.

Remembering Andy Griffith

The television play No Time for Sergeants was the breakthrough for Griffith and for adapter Ira Levin (yes, that Ira Levin), both of whom would take the show on to a successful Broadway run and a popular film. 

"America's wealth gap -- in 1776"

The good people at Marketplace have a sharp Independence Day spin on a big ongoing story.

Jeffrey Williamson: In 1774, the top 1 percent of households got 9.3 percent of income. 

Compare that to America today, when the top 1 percent is bringing in about 20 percent of income. Nine percent, versus 20 percent. Wow. 

Williamson: Wow. 

Even when you include slaves, Williamson says America was actually the most egalitarian country in the world when it came to the difference between rich and poor. 

So what did the founding fathers have to say about that? I called up a guy who should know. 

Clay Jenkinson: Hello my dear citizens, this is Thomas Jefferson. 

Actually it's Clay Jenkinson, a historian and Jefferson impersonator. And he says the writer of the famous phrase -- "All men are created equal" -- thought a lot about income inequality. In a letter to a friend describng the 13 colonies, he wrote "The great mass of our population consists of laborers. The rich, being few and of moderate wealth..." 

Jenkinson (Quoting Jefferson): Can any condition of society be more desireable?

I realize that we shouldn't treat the writings of the Founding Fathers as sacred text but you know they were pretty sharp...

Majorities

Sean Rust:

What this means is that unionization can be forced on 49 workers by the vote of 51. This type of system disenfranchises and forces fees of those who may not regard the union as a benefit in the workplace.

There is an odd sort of thinking that has been going on in libertarian circles about just how free the right of entry or exit should be.  In this case (a nearly evenly divided workforce), one side or the other is not going to get the outcome that they desire.  Why do we privilege the "don't want a union" side over the "want a union" side? 

This seems to be the same issue with democracy.  There are lots of decisions made in a democratic state that I do not agree with.  But at some point we need to decide how to organize groups.  Giving a small group veto power over change simply removes adaptability from the society as whole.

Now in terms of the post, itself, minority unions might be fine.  What one has to deal with are the asymmetries of power in the situation.  A recent discussion about these issues asked if a boss could make sexual relations part of the employment situation, on the premise that the employee always had the right to quit their job.  In a world without leases and with easy employment this might be true, but it clearly does not define the actual world we live in.  In the same sense, minority unions would be very interesting ideas in a world where the employer could not just ignore the striking minority union and hire more non-union workers. 

More on Felix and Education

Some choice quotes and reactions from Felix Salmon's recent post (already mentioned by Mark)

One big axis of tension is between the long-term view of the teachers and the unions, on the one hand, and the shorter-term view of pretty much everybody else, on the other. Is it possible to radically transform an entire educational system during the tenure of a single elected official, or before your tween enters high school? Realistically, no, it isn’t. Good teachers and good principals stay in the same place for decades and tend to take a long view of things; politicians and parents and children and venture capitalists, on the other hand, don’t have that kind of luxury. As a result, they tend to want to do big, drastic things which could have immediate results, whether it’s nationwide testing, or vouchers, or charter schools, or a multi-billion-dollar wiring of classrooms, or a mass culling of underperforming teachers, or a large-scale move onto some trendy new online educational platform.

One element that is neglected here is the problem that fast moves that show short term gains could work out very badly in the long run.  For example, simply by breaking one's word on pensions it is possible for a politician to look like a fiscal genius.  But the long term erosion of trust can actually result in worse outcomes. 

But there’s a really big problem here, and that’s the strong move on the part of reformers to fire underperforming teachers. The first thing you need to know if you want to fire the underperformers, of course, is who those underperformers are. And the best way to find that out is to use all that lovely new ed-tech data. As a result, teachers tend to be very suspicious of any attempt to collect data about them and their students: they fear that such moves are a means of collecting dubiously-reliable empirical evidence which will ultimately end up getting many of them fired.

I am unclear why firing teachers has become such a popular talking point.  Why have we, as a society, become convinced that firing is a good plan?   I think that the reason is that "tests" are becoming the entry point to social status.  So a bad teaching experience could have massive life-long effects on the students (simply because we make the tests so high stakes). 

But the idea that data should be used to train and educate teachers to do a better job seems to be somply beyond the pale.  And I am unclear why that would be so.  Do we really think a culture of fear and instability provides a better working environment or improves performance? 

In which case, how should bad teachers be fired? I do have sympathy for reformers and parents who put that action at the top of their to-do lists, and I’m even willing to believe the assertion, which I heard a few times at Aspen, that a handful of bad teachers can end up significantly bringing down the performance of an entire school. At the same time, however, if you look at say Finland, or some similar educational system with very high outcomes, you’ll also find almost no teachers being fired. Or, to put it another way: if bad teachers can bring down the performance of a school, then good schools can bring up the performance of all their teachers. Look at the various super-principals who get occasional gushing media coverage: they can turn around schools, given time, and generally don’t need to fire many or even any teachers in order to do so.

I love this switch -- why are we so focused on individual teachers and not the school environment itself?  I think that the short term fix environment is the reason.  I don't care about future kids -- I care about my child who is with Mrs. X right now.  I don't care about 5 years from now, I care about what happens before the next election. 

But the long term result of this will be to focus teachers on individual performance numbers.  And if you think that is a good plan, just think of how you would react in a position of constant instability and fear where a few numbers can change your life? 

Speaking of essential reading

Twilight of the elites is simply the must ready book of the year (if not the decade).  I am 25% through it via Kindle and it has already pointed out how standardized educational testing is doomed to failure so long as there are resource imbalances (simply due to the test preparation industry and the ability of the elite to hire tutors).  It also points out that, when we tolerate corruption, bad practices drive out good.

A lot of the book challenges my intuitions (as I am a meritocrat myself,by nature) but it points out some real limitations to the way we have arranged society.  It seems that inequality of outcome is a serious problem for a meritocracy (and there is still 75% of a book to go)!

If nothing else, this book makes the case for regulators (with teeth) being vastly more important in a meritocracy (which us the opposite of the idea of getting government out of the way).

Definitely work a few minutes.

Of course, people hate taxes, but they love paying penalties

Josh Marshall is wondering how many of his colleagues will acknowledge the obvious.

Whether you want to call the ACA health care mandate a tax or not is mainly a semantic point. It’s a penalty or tax or perhaps a tax penalty on people who refuse to purchase health insurance, even after they received subsidies that make it possible. But Republicans are now saying it’s the ‘biggest tax increase in history’ — either of America or the universe of whatever. But this is demonstrably false. 

The Congressional Budget Office says the mandate penalty will raise $27 billion between 2012 and 2021. $27 billion over a decade. Anybody who cares to can do the math. But if you want to call it a ‘tax increase’ — which is debatable — it’s clearly one of tiniest ones in history.
I’d be curious how many interviewers are (or are not) stopping folks who make this claim and pointing out this fact. Send me examples.

It's amazing how quickly silly ideas can become part of the standard narrative and how willing journalists are to accept silliness once it becomes part of that narrative. I know you've heard this before if you're a regular but journalism is in such a rotten state not just because standards have declined but because the profession has adopted an incredibly self-serving code of behavior that justifies the decline. Journalists who don't have the courage to confront liars or the dedication to get at the truth can point to the industry's peculiar definitions of balance and objectivity and say they're just doing their jobs.

There are journalists who do good work, but they do so in spite of their profession's code. That's not how the system is supposed to work.